Publication Date

Spring 2015

Document Type

Project Summary

Degree Name

Doctor of Physical Therapy

Department

Physical Therapy

First Advisor

Russell E. Carter, PT, Ed.D.

Second Advisor

Rebecca K. Wojcik, PT, Ed.D., GCS

Third Advisor

Roberta O'Shea, PT, DPT, Ph.D.

Abstract

Background/Purpose: The purpose of this case report is to describe the interventions that were implemented for a patient with hospital-acquired pneumonia with multiple co-morbidities.

Case Description: The patient was a 76 year old Caucasian male who was status-post 3.5 weeks in acute care and 11 days in the ICU secondary to hospital-acquired pneumonia and elevated troponin levels. The patient presented with decreased lower extremity strength, impaired balance, and difficulty with bed mobility, transfers and gait. The patient underwent endurance training and weaning of supplemental oxygen to return to prior level of function. Assessments were performed on a weekly basis. Outcome measures included the Tinetti Balance Assessment and the 30 Second Sit-to-Stand test.

Outcomes: Upon completion of physical therapy, the patient improved bilateral lower extremity strength, balance and gait. Tinetti Balance Assessment scores increased by 1 point from week 3 to week 5 and the 30 Second Sit-to-Stand test showed an increase from 6 successful transitions to 9 from week 2 to 3. At the termination of PT the patient was able to return home independent in self-care and ambulating with a 4-wheeled rolling walker.

Discussion: This case report demonstrated that it is possible to improve the functional independence in male older adults with complex medical issues, which have had a diagnosis of hospital-acquired pneumonia. Future research should focus on comparing the energy expenditure of utilizing a rolling walker versus a 4-wheeled walker.

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